Mark Beverly, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY-T-000071 Issued in AZ

Practice address

PO Box 617
Somerton, AZ 85350-0617

Phone

(928) 315-7910

Fax

(928) 722-6113

NPI assigned

Nov 13, 2024

Last updated

Oct 30, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• San Luis Walk-in Clinic, Inc.

  • Rural Health Clinic/Center
  • San Luis, AZ
  • NPI 1104228337
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793318400000",
    "number": "1023832375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11417 W PICCADILLY RD",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853923428",
            "telephone_number": "805-200-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 617",
            "city": "SOMERTON",
            "state": "AZ",
            "postal_code": "853500617",
            "telephone_number": "928-315-7910",
            "fax_number": "928-722-6113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVERLY",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-13",
        "last_updated": "2026-10-30",
        "certification_date": "2026-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "94028875",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "94028875",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "PSY-T-000071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• American Eagle Boys Ranch, LLC
• Norma Arreola, MASTERS
• Jody Marie Attaway
• Stephen Douglas Bailey, ED. D.
• Miriam G Beltran
• Jacob Richard Bromley, OD
• James Burrell
• Alberto Cabrera Jr., FNP-BC
• Campesinos Sin Fronteras
• Angelica Carlos

• Clinical Psychologist in Somerton, AZ
• Providers in Somerton, AZ by specialty
• Clinical Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.